DD Form 1222: Request for and Results of Tests

DD Form 1222 PDF Details

Enter the submitting office or contractor information in FROM and the testing facility or laboratory information in TO.

Reason for submittal: list reason for testing, e.g. First Article, Production Lot Acceptance, Shelf-Life Extension, special, etc.

Date submitted: enter date sample is shipped to laboratory (YYYYMMDD).

Sample number: sample numbers should be assigned for each sample; they can be created by the submitting activity or laboratory.

MQCSS/QSL review: applicable to shelf-life extension testing only; check block that you verified the lot/batch has not already been tested.

Send report of test to: list of people or mailboxes that should receive the test results/report.